Stark Statute 18 articles

A Columbus, Ga., hospital system and an affiliated physician have agreed to pay the U.S. and State of Georgia more than $25 million to settle a whistleblower’s allegations that they violated the federal False Claims Act, the Stark Statute, and the Georgia False Medicaid Claims Act. The settlements resolve two lawsuits filed by Richard Barker, a former Columbus Regional executive, in federal court in Columbus, Ga.  Mr. Baker filed the lawsuits under the whistleblower provisions of the federal and state False Claims Acts, which permit individuals to sue on behalf of the federal and state governments and share in any ... Read More

Three whistleblowers will share an award of nearly $6 million for their role in helping the federal government recover $21.75 million from a Texas hospital that allegedly profited by maintaining improper financial relationships that violated the Stark Statute and the False Claims Act. According to the U.S. Justice Department, the three whistleblowers, Dakshesh “Kumar” Parikh, Harish Chandna, and Ajay Gaalla sued Citizens Medical Center in Victoria, Texas, under the qui tam provisions of the False Claims Act. The whistleblowers alleged that the hospital, which is owned by Victoria County, Texas, over-compensated several cardiologists for the services they provided and paid bonuses to ... Read More

Fraud, abuse, mismanagement, and other forms of wrongdoing are all too common in both the private and public sectors of society these days – an unfortunate fact that elevates the role of the whistleblower in the fight against misconduct and corruption. With lawyers seeing more and more potential whistleblower cases pour in, it’s vital that whistleblowers properly document and state their case before taking it to a lawyer for review. After whistleblowers select experienced and competent legal counsel for their False Claims Act case, they should prepare a concise and well documented “pitch.” The Taxpayers Against Fraud (TAF) Education Fund ... Read More

Caremark LLC, a pharmacy benefit management giant operated by CVS Caremark Corporation, will pay the U.S. $6 million to settle allegations brought by a whistleblower under the False Claims Act that the company knowingly defrauded federal and state Medicaid programs by failing to reimburse the taxpayer-funded programs for drug expenses that should have been paid by the private insurer. Individuals who are covered by both Medicaid and a private health plan are classified as “dual eligible.” U.S. law mandates that the private insurer, rather than taxpayer-funded government programs, must assume the costs of health care for dual eligible beneficiaries. Should Medicaid erroneously ... Read More

Shire Pharmaceuticals has agreed to pay the U.S. $56.5 million to settle two whistleblower lawsuits filed by former employees of the company who alleged the company illegally marketed several drugs for unapproved, off-label purposes and then billed Medicare, Medicaid, and other taxpayer-funded health care programs for them. Dublin, Ireland-based Shire operates in the U.S. out of its facility in Wayne, Penn. The company makes and markets Adderall XR, Vyvanse, and Daytrana, which are approved for the treatment of attention deficit hyperactivity disorder (ADHD), and Pentasa and Lialda, which are approved for the treatment of mild to moderate ulcerative colitis. The ... Read More

Federal prosecutors have widened their crackdown on a $56-million health care fraud scheme in the New Orleans area, announcing charges against seven more individuals, including two physicians, who allegedly billed Medicare for home health care services that were not medically necessary or were never provided. The U.S. Justice Department announced Thursday that a New Orleans grand jury indicted the seven individuals, bringing the total number involved in the alleged fraud scheme to 13 defendants. The indicted individuals operated six health care companies. Federal prosecutors say the individuals participated in the scheme through these companies, billing Medicare for home health services ... Read More

Whistleblowers who help expose fraud and other misconduct in the financial world could earn bigger rewards in the future in exchange for the efforts, if U.S, Attorney General Eric Holder has his way. Threats brewing in the financial industry today have come to resemble some of the dubious greed-driven behaviors that devastated the U.S. economy in 2008 despite the government’s efforts to prevent a similar catastrophe from recurring in the coming years. “We are already witnessing a troubling return to some of the very same profit-driven risk-taking that contributed to the 2008 collapse,” Mr. Holder said in a speech Wednesday ... Read More

Two lawsuits accusing Merck & Co. of lying about the efficacy of its mumps vaccines to keep competitors from introducing similar vaccines to the market will be proceed to trial after a federal judge in Pennsylvania refused to dismiss the suits. U.S. District Judge C. Darnell Jones II ruled that one of the lawsuits, filed by a pair of whistleblowers who worked as virologists for Merck, provided enough evidence that the pharmaceutical giant lied about the vaccine’s efficacy to the federal government. The judge also ruled that the other lawsuit, filed by a group of physicians and direct buyers, could ... Read More

The U.S. government has intervened in a whistleblower’s False Claims Act lawsuit against a Michigan neurosurgeon, a spinal implant company, two distributors, and the companies’ owners, alleging that the defendants conspired to perform medically unnecessary and excessive surgeries on patients for profit. The Justice Department also said that in addition to taking over the whistleblower lawsuit, it has filed a separate complaint against the same defendants for engaging in an illegal kickback scheme that put profits above patients’ needs. The whistleblower lawsuit was filed under the qui tam provisions of the False Claims Act by Dr. Caty Savitch and Dr. ... Read More

A New York federal judge has rejected Novartis Pharmaceutical Corp.’s bid to dismiss a whistleblower lawsuit alleging the company engaged in illegal kickback schemes involving two of its drugs, which resulted in false claims to Medicare and 27 state Medicaid programs. The lawsuit, filed under seal by whistleblower David Kester in 2011, was amended by the U.S. government in January, about nine months after it chose to intervene and take over the case as the U.S. False Claims Act allows it to do. Mr. Kester worked for seven years as an account manager for Novartis, a position that required him ... Read More